Evidence-based Practice for HINARI Users (Advanced Course Module 6 Part B) This module explains why HINARI users might want to start by searching evidence-based resources and highlights HINARI, as well as, freely available resources that support evidence-based practice. 20 May 2018

Table of Contents Evidence & EBM definitions 5 step EBM process HINARI Resources Cochrane Library Evidence-based Medicine Guidelines Essential Evidence Plus EBM Journals PubMed/Clinical Queries PubMed Filters Evidence Aid Other (Internet) Resources introduce you to Evidence-based Practice and related HINARI resources 20 May 2018

JBI Database of Systematic Reviews and Implementation Reports (JBI) JBI resources are primarily found through the Ovid platform, however, when it is feasible, some of the Protocols will be published through PROSPERO which is Open Access. Besides Systematic Reviews, JBI publishes: Best Practice Information Sheets Consumer Information Sheets Evidence Summaries Recommended Practices Systematic Review Protocols Systematic Reviews and Technical Reports 20 May 2018

Two Methods for Searching JBI: The first is article searching No advanced Search Best bet when you have an article title/volume/issue Retrieval Path Click on J from the Journals Collection Find the JBI Database of Systematic Reviews and Implementation Reports Note: There are two options. Choose the year range that is appropriate for your citation. 20 May 2018

JBI Database of Systematic Reviews and Implementation Reports: Article Searching Note the Article searching options. Enter Keywords and also use the All Issues option. 20 May 2018

Article Searching through JBI Database Advanced Search Search the journal issue list Using Date, Volume, issue and page number The Advanced Search is a simple title, author, etc search. Keyword/subject search; generally used when you have no citation available; this method searches 2003 to present; from volume 1/issue 1 20 May 2018

Open the Joanna Briggs Institute EBP Database from the Browse databases list -another option for locating subject- specific material. 20 May 2018

Check All Resources and click on OK. 20 May 2018

To search for just JBI materials, perform a Multi-Field Search. Type JBI in the search box, and in the drop down menu select Journal Words. Enter specific search – Blood donation with All Fields – in the box below. Open Search History above to see more details. 20 May 2018

Field limiters available in the OVID Database for JBI: Abstract – to ensure you are coming up with the best search possible, search for keyword; should only be used for main phrase terms; note: you will lose any material without an abstract Title - this is very specific and searchers should be very careful to only search the most specific term using this method Text Word – the text word limiter searches both Abstract and Title 20 May 2018

Example Search – JBI & infectious diseases and Africa The results for this search are 26 that will be opened by clicking on Display Results. 20 May 2018

From the Reference sources list, we have opened the initial page of EBM Guidelines Evidence-Based Medicine. Also published by John Wiley, this resource is a collection of clinical guidelines for primary care combined with evidence-based research. You can Search by keyword or Browse database contents by EBM Guidelines, Evidence summaries, Pictures, Audio samples, Videos and Programs. 20 May 2018

Also included are links to the Evidence summaries. We have completed a keyword search for Influenza. The results page includes summaries of the key issues including Related resources and References and links to important websites. PRIMARY and SECONDARY HITS Also included are links to the Evidence summaries. 20 May 2018

We have displayed the 2nd Evidence summary We have displayed the 2nd Evidence summary. Each link contains a brief review of the study and notes the reference(s). 20 May 2018

By keyword, you can Search all or some of the databases. From the Reference Sources list, we have opened the initial page of Essential Evidence Plus. Also published by John Wiley, it includes access to Cochrane Library and also a series of databases and tools to access the EBM material. By keyword, you can Search all or some of the databases. 20 May 2018

We have opened the EBMG evidence summaries database that, via broad subject categories, has access to 4440 articles. 20 May 2018

We have opened the initial page of EBMG evidence summaries listing for Infectious disease. Material is listed by either a summary view or expanded view that includes a sentence describing each entry. 20 May 2018

We have opened Decision Support Tools that has 406 tools and calculators that assist in clinical decision making. 20 May 2018

HINARI Evidence-Based Journals (other journals may have EBM articles) We have browsed the ‘E’ in the HINARI Find journals by title list and it notes several journals for evidence-based practice. Depending on publishers’ offer to countries, some of these journals may not be accessible. 20 May 2018

Table of Contents – Part B Internet Resources PubMed/Clinical Queries PubMed Filters Evidence Aid Other (Internet) Resources introduce you to Evidence-based Practice and related HINARI resources 20 May 2018

Conduct systematic reviews of the literature (HINARI) PubMed Conduct systematic reviews of the literature Limit to specific populations & publication types Utilize EBM built-in filters Set up and distribute alerts relating to evidence-based medicine 20 May 2018

We now search for evidence-based articles using PubMed We now search for evidence-based articles using PubMed. From the HINARI Content page, go to PubMed by clicking on Databases for discovery list Remember you must login to HINARI to have access to the full-text articles. In the HINARI Portal you can access PubMed from the Content page. Click on Search inside HINARI full-text using PubMed. 20 May 2018

Open PubMed which is at the top of the Browse databases list. 20 May 2018

Open the Clinical Queries box Open the Clinical Queries box. This search tool assigns filters to keyword searches - to locate articles on Clinical Studies, Systematic Reviews and Medical Genetics. Note: for these PubMed applications, all individuals will have access to the free full text articles. The examples are from HINARI/PubMed searches and, for those properly logged in, will also include access to articles from HINARI participating publishers. 20 May 2018

On the PubMed Clinical Queries page, we have entered the pregnancy pregnancy complications AND developing countries search. 20 May 2018

Note the Category and Scope options for Clinical Studies Categories Etiology Diagnosis Therapy Prognosis Clinical Prediction Guides Scope Broad Narrow 20 May 2018

Note: you can go directly to PubMed Clinical Queries. The default search results for the Clinical Study Categories are Category: Therapy and Scope: Broad. Other options in the Category drop down menu are Etiology, Diagnosis, Prognosis and Clinical Prediction Guides. There are 1357 articles for Therapy: Broad and 165 articles for Systematic Reviews. Note: you can go directly to PubMed Clinical Queries. The direct link to PubMed Clinical Queries is http://www.ncbi.nlm.nih.gov/pubmed/clinical 20 May 2018

For the Scope option, we will enter Narrow and for the same pregnancy complications AND developing countries search. 20 May 2018

The Therapy (Category) and Narrow (Scope) pregnancy complications AND developing countries search has resulted in 145 citations. We now will click on the See all option (bottom of the page). Note that the results for Systematic Reviews and Medical Genetics also are displayed. 20 May 2018

We have displayed all 145 articles for this search including 80 HINARI and 80 Free Full Text articles. Remember - you can access the full-text articles by clicking on these Filters or changing the display from Summary to Abstract. Note that the specific search is listed in the Search box including the AND (Therapy/Narrow[filter]) for clinical studies categories and systematic reviews. Note: from a search results page, return to Clinical Queries by clicking on the PubMed.gov logo as this displays the initial PubMed Search page. 20 May 2018

After returning to the search results on the Clinical Queries page, we have clicked on the See all option for the systematic reviews results. The pregnancy complications AND developing countries AND systematic [sb] search resulted in 165 articles. 20 May 2018

Another tool from PubMed is using the Filters option – see the left-column. In the Article types filter list, click on Customize. Check the boxes for Meta-Analysis, Randomized Control Trial and Systematic Reviews Article types. Finally, click on the Show box. Filters can be activated from any search results page. Remember to clear them before beginning other searches. 20 May 2018

Note how the various Filters have been displayed under the Article types list. You now can use of the filters with the hypertension AND diet search. 20 May 2018

We have checked the Meta-Analysis box in the Article types section and entered hypertension AND diet in the PubMed Search box. The search Results number is 86. Note the Filters activated: Meta- Analysis line below the Results number. 20 May 2018

Now displayed are the results of a hypertension AND diet search with the Systematic Reviews Article types filter activated. The citations for this search include 109 Free Full text and 167 HINARI articles. 20 May 2018

Now displayed are the results of a hypertension AND diet search with the Randomized Controlled Trial Article types filter activated. The citations for this search include 371 Free Full text and 689 HINARI articles. 20 May 2018

Remember to clear the filters. The final displayed search are the results of a hypertension AND diet search with the Meta-Analysis, Systematic Reviews and Randomized Controlled Trial Article types filters activated. The citations for this search total 1598. Remember to clear the filters. 20 May 2018

Another useful tool is evidenceaid Another useful tool is evidenceaid. The Resources page contains links to numerous published systematic reviews that have relevance for natural disasters, humanitarian crises or major healthcare emergencies. It also includes five disaster-specific Special Collections. 20 May 2018

To learn more about EBM, go to the online tutorial Introduction to Evidence-Based Medicine. Tutorial is intended for any health care practitioner who needs a basic introduction to the principles of Evidence-Based Practice. Developed by Duke University Medical Center Library and Health Sciences Library/University of North Carolina/Chapel Hill. 20 May 2018

Additional Evidence-based Health Resources continued Trip Database – ‘a smart, fast tool for you to find high-quality clinical research evidence’ www.tripdatabase.com/ McMaster PLUS (Premium Literature Service): ‘a database created by the McMaster Health Knowledge Refinery; articles… selected from current medical literature’ (HKR)hiru.mcmaster.ca/hiru/HIRU_McMaster_PLUS_projects.aspx 20 May 2018

Bandolier Knowledge - Oxford University – ‘premier source of evidence based healthcare information in the UK and worldwide for healthcare professionals’ http://www.bandolier.org.uk/ EBM Librarian – ‘site offers a place to: share teaching materials and class handouts discuss issues and ask advice from colleagues share useful information about teaching EBM https://sites.google.com/site/ebmlibrarian/ Listed here are some freely available websites that are useful resources for finding clinical and public health evidence. 20 May 2018

Open Clinical: Clinical Practice Guidelines – ‘a "one-stop shop" tracking developments on advanced knowledge management technologies for healthcare such as point-of-care decision support systems, "intelligent" guidelines and clinical workflow’ www.openclinical.org/guidelines.html National Guidelines Clearinghouse - Agency for Healthcare Research and Quality: ‘a public resource for summaries of evidence-based clinical practice guidelines’ www.guideline.gov/ 20 May 2018

Evidence Alerts - McMaster University/DynaMed Plus – ‘access to current best evidence from research’ plus.mcmaster.ca/evidenceupdates/ Equator Network Reporting Guidelines: Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement http://www.equator-network.org/reporting-guidelines/prisma/ 20 May 2018

Additional Clinical Practice Guidelines resources National Guideline Clearinghouse (USA) www.guideline.gov/ Open Clinical: Clinical Practice Guidelines www.openclinical.org/guidelines.html 20 May 2018

Review: 5 Steps to evidence-based health care Step 1 Ask: Formulate your question foreground clinical question PICO format population, intervention, comparison intervention, outcome Step 2 Access: Search for the evidence – highest quality studies are included in a systematic review types of studies evidence hierarchies  Here are some general comments to remember about evidence-based practice. We hope that this tutorial has led to a better understanding of what evidence-based practice is and how to efficiently find good evidence using HINARI resources. 20 May 2018

validity (internal & external) impact Step 3: Appraise the evidence - use criteria to evaluate the studies for: validity (internal & external) impact Step 4 Apply: Put the evidence into practice patient setting Step 5: Assess progress and performance yourself 20 May 2018

This is the end of HINARI Module 6 There is a Work Book to accompany this part of the module. The workbook will take you through a live session covering the topics included in this demonstration with working examples. Updated 2018 06 20 May 2018